WEBVTT 00:00.000 --> 00:09.360 My name is Conrad Steiner. I'm a doctor of medicine. Tonight's story of the title, A 00:09.360 --> 00:23.680 Time to be Alive. Guardian of birth, healer of the sick, comforter of the aged. To the 00:23.680 --> 00:39.800 profession of medicine, to the men and women who labor in its cause, this story is dedicated. 00:39.800 --> 00:45.480 Tonight's presentation, the field of hematology, science of blood. The object in point, a piece 00:45.480 --> 00:52.760 of jagged glass. The case in point, David Carter Stinson. He's 11 years old. From the 00:52.760 --> 00:58.200 day he was born, his life's been in constant jeopardy. A simple cut, an unlucky fall, a 00:58.200 --> 01:02.280 bruise, any of these could mean death for him. His condition is sometimes referred to 01:02.280 --> 01:08.400 as the royal disease, the malady of kings. But David's not a king. He's just a young 01:08.400 --> 01:18.200 boy in a lot of trouble. David, tell the class who captured Mexico City at what? David? David, 01:18.200 --> 01:25.880 are you listening? In November 1519, Fernando Cortez marched on the Aztec capital, Mexico 01:25.880 --> 01:30.520 City. The emperor, Montezuma, thinking he was a descendant of the sun god, offered no 01:30.520 --> 01:38.760 resistance. And in a short time, Cortez controlled all Mexico. Seamus Walker, did they ever find 01:38.760 --> 01:45.400 those three men that landed near Cuernavaca? Little men. David, is that in your copy of 01:45.400 --> 01:51.240 Mexico, Land of Sunshine and Mañana? No, it's in Science Weekly Report, Miss Walker. 01:51.240 --> 01:59.160 They came by saucer. Class, David tried to stay with the text. Anyway, they couldn't 01:59.160 --> 02:07.160 have come to Cuernavaca. There isn't an airport within miles. And now, class, David, tomorrow 02:07.160 --> 02:12.920 we'll cover the principal industries and major cities. This is David Stinson, and this room 02:12.920 --> 02:17.480 has been the boundary of his world for more than two months. No great disaster put him 02:17.480 --> 02:24.680 there. He simply fell off a bike and bumped his knee. For most boys, the treatment would 02:24.680 --> 02:28.920 have been a piece of adhesive tape and a chocolate soda. But for David, it meant two weeks in 02:28.920 --> 02:34.840 a hospital, four pints of blood, an orthopedic brace, and agonizing pain whenever he moves 02:34.840 --> 02:42.280 his leg. For David, Carter Stinson is a hemophiliac. He's a bleeder. When he cuts himself, it doesn't 02:42.280 --> 02:46.120 stop, and it takes all the arts of medicine to keep his heart from pumping his life out 02:46.120 --> 02:53.080 through the open wound. And this is his mother. From the day David was born, it's been her 02:53.080 --> 03:02.280 job to say no. No bicycle, no baseball, no football, no running, no jumping. Almost every 03:02.280 --> 03:07.160 normal interest a boy could have, it's been her job to say no. But she watches over him 03:07.160 --> 03:13.880 fiercely, torn with two emotions, love and guilt. The guilt, she blames herself for her 03:13.880 --> 03:38.840 son's disease. 04:13.880 --> 04:39.160 An hour later, David Stinson is brought into surgery. The radial artery in his left forearm 04:39.160 --> 04:45.440 has been cut, and he's sustained lacerations around the mouth and chin. The impact of his 04:45.440 --> 04:52.280 fall has also re-injured his left knee, causing internal hemorrhage around the joint. He's 04:52.280 --> 04:57.360 lost considerable blood. On arrival at the hospital, he was given two units of antihemophilic 04:57.360 --> 05:08.320 plasma. He's approaching shock. Blood pressure 70 over 40, pulse 160. The cut in his arm 05:08.320 --> 05:14.040 is sutured and a pressure bandage with fibrin foam applied. His face presents another problem. 05:14.040 --> 05:18.200 The lacerations are not as deep and can be easily sutured, but the application of a pressure 05:18.200 --> 05:23.960 bandage is extremely difficult in this area. Because the patient is a known hemophiliac, 05:23.960 --> 05:28.520 a cross-match is run immediately and six units of fresh blood are ordered. The blood must 05:28.520 --> 05:33.240 be fresh, for the vital protein antihemophilic factor, which is lacking in the patient's 05:33.240 --> 05:38.400 blood, the same protein which causes normal blood to coagulate, loses its effectiveness 05:38.400 --> 05:42.960 24 hours after it's taken from the donor. In order to ensure a sufficient supply of 05:42.960 --> 05:47.520 fresh blood on hand, a call is sent out to all available sources in the area requesting 05:47.520 --> 05:54.120 blood of the patient's type. Meantime, outside the hospital corridor, David's family waits, 05:54.120 --> 06:02.840 hopes, and prays. His father, mother, his sister. Her name's Flora. She's 21 years old. 06:02.840 --> 06:08.160 She's engaged to be married. Like her parents, this is hardly a new experience for her. She's 06:08.160 --> 06:12.400 been through it time and again. And with each new episode, a growing fear takes hold in 06:12.400 --> 06:22.240 her mind. A fear not only for her brother, but for herself. Three hours later, the patient 06:22.240 --> 06:26.480 is on his third unit of blood and is still bleeding. For the moment, the transfusions 06:26.480 --> 06:33.480 have removed the danger of shock. 06:33.480 --> 06:53.280 This makes 1,500 cc's. He's a sick boy. Seems there's enough AHF in the blood we've given 06:53.280 --> 06:59.600 him to induce clotting. It's not quite that simple, Carl. Hemophiliacs not only lack the 06:59.600 --> 07:04.400 AHF factor in the blood, they tend to resist it. Sometimes one of them will build up antibodies 07:04.400 --> 07:08.440 and fight it, the one thing that can save their lives. I heard about a patient that 07:08.440 --> 07:13.480 took 30 transfusions and was still bleeding when he died. What about isolating the AHF? 07:13.480 --> 07:18.560 I mean, so it can be administered in massive doses. Has anybody tried it? No, it's been 07:18.560 --> 07:24.080 tried experimentally. It's not too reliable yet. So far the best we've got is fresh blood 07:24.080 --> 07:29.840 and plasma. All we can do is what we are doing. I talked to George Fletcher, the hematologist. 07:29.840 --> 07:35.400 He agrees with the procedure we're following. Do you want me for anything? I'll be outside 07:35.400 --> 07:44.560 getting history from the parents. I'll be out as soon as I can. Right. Dr. Sterner, 07:44.560 --> 08:09.000 look at this. Doctor, is there any change? Well, he's shown some improvement since he 08:09.000 --> 08:14.280 came in, Mrs. Stinson. Nothing conclusive, but it's encouraging. I'd like to review David's 08:14.280 --> 08:21.280 record, if I may. It's full of hospital records. Surely. Won't you sit down, please? Thank 08:21.280 --> 08:29.480 you. Let's see now. Full name, David Carter Stinson. That's correct. When was he born? 08:29.480 --> 08:37.360 March 10th, 1943. Any childhood diseases? Chickenpox, measles. He never did have the 08:37.360 --> 08:41.880 mumps. And when was he first diagnosed as hemophiliac? When he was five days old. We 08:41.880 --> 08:50.280 nearly lost him, didn't we, Rose? What about some of the other episodes? There were so 08:50.280 --> 08:57.680 many. The next time was when I was a year old. He began to walk. For most mothers, it's 08:57.680 --> 09:05.080 quite an event. I dreaded it. I watched him every second, never let him out of my sight. 09:05.080 --> 09:14.080 It happened anyway. He fell and cut his lip. He bled for three weeks. Do you remember how 09:14.080 --> 09:20.080 many transfusions he received, Mrs. Stinson? Quite a few. I don't remember how many. I 09:20.080 --> 09:26.880 know it was a lot. When we took him back home, I was scared to death. Scared every minute 09:26.880 --> 09:34.480 that he was awake. Scared to pick him up. Scared to touch him. Scared even to kiss him. 09:34.480 --> 09:43.080 After that, it seemed to get better. Two or three years, he was acting like most kids. 09:43.080 --> 09:50.880 Dr. Steiner said that's the way it was. Sometimes it was better, sometimes it was worse. I thought 09:50.880 --> 09:57.080 maybe it was over. Do you know of any hemophilia in your family? I mean, did you ever know 09:57.080 --> 10:04.280 of any relatives that had it? No. No, I'd never even heard about it until Lady was born. 10:04.280 --> 10:11.280 They said it came from me. I gave it to him. I didn't know about it. I'd never even heard 10:11.280 --> 10:15.880 about it. That's true, Sam, isn't it? I didn't know anything about it. Of course not, darling. 10:15.880 --> 10:20.880 How could you? It wasn't your fault. It just happened. It's nobody's fault. When was the 10:20.880 --> 10:27.680 next time it showed up, Mrs. Stinson? Can you remember? When Davey was four, Sam bought 10:27.680 --> 10:36.280 him a rocking horse. He was beautiful. His eyes were old. He had skin like a real pony. 10:36.280 --> 10:47.080 Davey loved him. Then one afternoon, he fell off. He got a bruise, a bad one. Was he hospitalized 10:47.080 --> 10:56.880 for that? He was in for over a month. He had to wear a brace. And five years ago, he had 10:56.880 --> 11:04.880 a very bad one. We went to Yosemite. Davey fell off a rock, sprained his ankle. Oh, I 11:04.880 --> 11:08.680 know he shouldn't have gone there. I know he shouldn't have been on the rock. But how 11:08.680 --> 11:15.480 do you keep a kid chained up when he wants to run and jump with the rest of the kids? 11:15.480 --> 11:23.280 All you can do is hold him down until he looks at you like you've got peace. Then you take 11:23.280 --> 11:34.380 a chance. You take a chance and he's sorry for it. Flory saved his life. She was there 11:34.380 --> 11:41.480 when he fell. She was only 16, but she carried him all the way back to camp. Got a doctor. 11:41.480 --> 11:48.880 Rushed him to the small hospital in the park. Flory and I took turns sitting up. She nursed 11:48.880 --> 11:58.080 him as though he were her own child, not her brother. Always surprises you. Kids understand 11:58.080 --> 12:04.880 more than you think. Excuse me. Excuse me, is there a phone? Just down the hall, other 12:04.880 --> 12:28.880 side of the elevators. Thank you. I'll be right back. Jimmy, this is Flory. I'm still 12:28.880 --> 12:36.880 at the hospital. I've got to see you, Jimmy. I've got to see you right away. 12:58.880 --> 13:14.880 Flory, how are you doing? Hi. How's Davy? We don't know yet. I'm sorry to call you out 13:14.880 --> 13:19.880 so late. That's OK. You sounded so funny on the phone, kind of scared me. What's it all 13:19.880 --> 13:29.880 about? What's the matter? Jimmy, are you really thinking about marrying me? Is that what you 13:29.880 --> 13:35.880 brought me down here for? Answer me. Do you really want to marry me? Well, I think so, 13:35.880 --> 13:41.380 Flory. I mean, look, we talked about it, you know, later on. Gee, do we have to set the 13:41.380 --> 13:47.880 date right now? Do you really know what Davy's trouble is? Sure, he's kind of sickly. He 13:47.880 --> 13:58.880 gets hurt easy. He's a hemophiliac. He's a bleeder. We get married, we have a baby, a 13:58.880 --> 14:06.880 boy. He could be just like Davy. Well, how come? You're from the same family. You didn't 14:06.880 --> 14:15.880 get it. No, I give it. Women aren't affected by it. They only give it. I'm a carrier. How 14:15.880 --> 14:21.880 do you know? There's no way of knowing for sure. Not until I have a baby. But there must 14:21.880 --> 14:27.880 be some kind of a test. There must be some way of telling. There isn't. All I know is 14:27.880 --> 14:33.880 it's in the family blood, and it could be in mine. If I've got it, I could pass it on 14:33.880 --> 14:50.880 to my kids. Flory. You're probably worrying about nothing. You're probably perfectly 14:50.880 --> 14:57.880 all right. And if I'm not, would that be all right with you? Spend your life in hospital 14:57.880 --> 15:03.880 hallways. Have a kid you can't have any fun with. Watch him every minute of the day and 15:03.880 --> 15:09.880 night. Is that all right with you? Talk to my father. Ask him what it's like. Ask him 15:09.880 --> 15:13.880 how many times he's gotten phone calls at work. How many times he's come home and seen 15:13.880 --> 15:17.880 a crowd around the house and an ambulance waiting out in front. Ask him how many nights 15:17.880 --> 15:24.880 he's slept in the hospital waiting room. Like he's doing tonight. Sure, he wanted a son. 15:24.880 --> 15:36.880 It's what he always wanted. He finally got one. David. And what is he? A little kid. 15:36.880 --> 15:42.880 Almost like a glass doll. I'm propped up in a bed most of the time. Just so you're even 15:42.880 --> 15:48.880 afraid to touch him because you might start him bleeding. Is that the kind of life you 15:48.880 --> 15:53.880 want? You want kids like that? Would that be all right with you? Do you want me that 15:53.880 --> 16:09.880 much? You better go home, Jimmy. I said you better go home. 16:09.880 --> 16:24.880 You're all wrong. 16:24.880 --> 16:28.880 Seven hours later and there's still no great change in the patient's condition. By now 16:28.880 --> 16:32.880 there's every indication that this patient is a refractory case and may continue to bleed 16:32.880 --> 16:38.880 indefinitely. Blood pressure 120 over 80. Pulse 90. Both stable for the last four and 16:38.880 --> 16:43.880 a half hours. Transfusions of whole fresh blood continue. If they were to be stopped 16:43.880 --> 16:47.880 it would be only a matter of time before the patient went into shock and died from loss 16:47.880 --> 17:11.880 of blood. 17:11.880 --> 17:40.880 The pressure bandage is changed at regular intervals. 17:40.880 --> 17:47.880 The pressure bandage is changed at regular intervals. 18:10.880 --> 18:23.880 Never mind that, Carl. We won't need it now. 18:23.880 --> 18:26.880 What is it? 18:26.880 --> 18:36.880 He stopped bleeding. 18:36.880 --> 18:41.880 He's so pale. He hardly seems to be breathing. He's all right. We have him under pretty heavy 18:41.880 --> 18:45.880 sedation. There's no need to wake his mother, is there? I don't think so. Not unless you 18:45.880 --> 18:48.880 want to. 18:48.880 --> 18:53.880 Eleven years old. He's the top of his class in school. If they want him to make a speech 18:53.880 --> 18:58.880 when he graduates... He's a bright boy, Mr. Stinson. You ought to be proud of him. Is he 18:58.880 --> 19:03.880 going to live, doctor? Well, he came out of it this time. If he's careful, no more accidents, 19:03.880 --> 19:07.880 no major cuts or bruises. He ought to make out pretty well for the time being, at least. 19:07.880 --> 19:09.880 What about the future? 19:09.880 --> 19:11.880 Well, that's pretty hard to say. 19:11.880 --> 19:15.880 Well, what is it hard to say? What can you tell me that I can take to his mother so she 19:15.880 --> 19:19.880 wakes up with a smile for just once in her life? 19:19.880 --> 19:22.880 The boy's alive, Mr. Stinson. Twenty years ago he'd have been dead. 19:22.880 --> 19:29.880 Alive? Alive for what? So he can spend his life in hospital beds with braces and wheelchairs? 19:29.880 --> 19:31.880 It's all right to come outside, Mr. Stinson. We can talk about it at that. 19:31.880 --> 19:34.880 What can you tell me outside that you can't tell me in here? 19:34.880 --> 19:36.880 I can tell you the truth. 19:41.880 --> 19:47.880 There's a man in Michigan and another one back in Massachusetts. They've isolated the 19:47.880 --> 19:52.880 protein in normal blood that your son lacks. He's got a lot of problems with it. It may 19:52.880 --> 19:57.880 be months, it may be years before it can be used clinically, but there it is. Somebody's 19:57.880 --> 20:02.880 doing something about David's trouble. Maybe tomorrow they'll find the answer. Maybe the 20:02.880 --> 20:09.880 day after. But they're going to go on looking for it. That's all I can tell you, Mr. Stinson. 20:09.880 --> 20:15.880 You've got a sick boy, but you're not alone with him. There are people working. They're 20:15.880 --> 20:20.880 only humans. They've got to do a lot of work before they finally hit on the right answer. 20:20.880 --> 20:29.880 But when they do, they come up with insulin, sulfa, penicillin, the mycin drugs. Tomorrow, 20:29.880 --> 20:36.880 maybe a year from tomorrow, the man in Michigan or maybe the man back in Massachusetts, maybe 20:36.880 --> 20:40.880 they'll finally hit on the right answer. Kids like David can jump on their bikes and not 20:40.880 --> 20:42.880 worry about bumps, bruises. 20:42.880 --> 20:45.880 How about David? Does he have five years, doctor? 20:45.880 --> 20:47.880 Maybe five, maybe 50. 20:47.880 --> 20:53.880 You know, the graduation's in two weeks. He's supposed to make the speech. It's a big thing 20:53.880 --> 20:55.880 for him. Can he go? 21:06.880 --> 21:13.880 David Stinson, I, Wanda Mead, the vice president of the graduating class of Jefferson Drama 21:13.880 --> 21:18.880 School, am proud to congratulate you on your achievement as honor student of the class 21:18.880 --> 21:23.880 of 1954. I now present our class president, Michael Elliott. 21:25.880 --> 21:30.880 David Stinson, I, Michael Elliott, as president of the graduating class of Jefferson Grammar 21:30.880 --> 21:34.880 School, am proud to congratulate you on your achievement as honor student of the class 21:34.880 --> 21:40.880 of 1954. Even though you were in attendance only 72 days during the school year, your 21:40.880 --> 21:44.880 record was outstanding and you were chosen valedictorian by the students and teachers 21:44.880 --> 21:46.880 of the class. It is my... 21:49.880 --> 21:54.880 It is my privilege to present you with this award in token of your achievement. 21:56.880 --> 21:57.880 Thank you, Michael. 22:02.880 --> 22:07.880 And now I'd like to present our valedictorian, David Stinson. 22:07.880 --> 22:17.880 Thank you, Miss Walker. Miss Walker, fellow students, first let me thank you for your 22:17.880 --> 22:26.880 gifts and for having elected me valedictorian. What does valedictorian mean? Valedictorian 22:26.880 --> 22:35.880 means the one who gives the valedictory. What does valedictory mean? Valedictory means of 22:35.880 --> 22:43.880 pretending to leave thinking or saying goodbye. And we are saying goodbye. Goodbye to childish 22:43.880 --> 22:50.880 thoughts and actions, to jungle gyms and sandboxes. Hello to a new life of work and play at junior 22:50.880 --> 22:56.880 high. But we must be thinking of what kind of men and women we will want to be in the 22:56.880 --> 23:02.880 far future of ten years from now. And we must ask ourselves, what does the future hold for 23:02.880 --> 23:11.880 me? Flory, I've been waiting for you. I'm late, Jimmy. It's Davy's graduation. I wish 23:11.880 --> 23:15.880 you'd listen to me first. It's important. It's been two weeks, Flory. I haven't seen 23:15.880 --> 23:19.880 you. I haven't called you. I suppose you thought I was trying to ditch you. Well, I'm not. 23:19.880 --> 23:23.880 You gave me a lot to think about, Davy and all this in the theater stuff. Well, I thought 23:23.880 --> 23:28.880 about it. I thought about every angle. It's time, Flory. I guess we've got to grow up. 23:28.880 --> 23:34.880 A month ago we were kids. We're not kids anymore. We both know the score. Well, that's all there 23:34.880 --> 23:40.880 is to it. I love you. I want to marry you. I want to have kids. I want to be with you. 23:40.880 --> 23:49.880 That's all I've got to say. What do you think? Well, I'm glad we got that settled. Which 23:49.880 --> 23:57.880 way is Davy's room? Come with me. So, fellow students, I say this is the most exciting 23:57.880 --> 24:05.880 time to be alive. Each of us, in his own way, is prepared to face his own future. Yes, nothing 24:05.880 --> 24:12.880 is impossible for those who have faith in the future. Fellow classmates, the world is 24:12.880 --> 24:21.880 our oyster. At the present time, research teams at hematological centers all over the 24:21.880 --> 24:26.880 country are at work attempting to find the cause and cure for hemophilia, the hereditary 24:26.880 --> 24:31.880 disease which lies passive in the female genes of a family for generations and then strikes 24:31.880 --> 24:36.880 the innocent with tragic force. Through the steps made by modern medicine to date, by 24:36.880 --> 24:42.880 transfusion of whole fresh blood and anti-hemophilic plasma, the lifespan of a hemophiliac has been 24:42.880 --> 24:48.880 increased from a few short years to an almost normal and useful period. There is no cure 24:48.880 --> 24:54.880 for hemophilia yet, but someday in the near future, a hemophiliac may be able to control 24:54.880 --> 24:59.880 his disease by injection, much like the injection of insulin for diabetes.